<![CDATA[End-stage renal failure (ESRD) is a global health issue requiring hemodialysis as a life-sustaining therapy. The insertion of an arteriovenous (AV) fistula, the primary vascular access for hemodialysis, often causes recurrent pain, impacting patient comfort and quality of life. Objective: To evaluate the pharmacological and non-pharmacological interventions for managing pain associated with AV fistula insertion in hemodialysis patients. Methods: A systematic review was performed by searching ScienceDirect, PubMed, EBSCO, and ProQuest databases. Articles were identified using Medical Subject Headings (MeSH) terms and relevant keywords related to hemodialysis, arteriovenous fistula, pain, and pain management interventions. Studies were screened following the PRISMA guidelines using Rayyan and critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Results: The database search identified 381 records. After screening and eligibility assessment, 17 studies met the inclusion criteria. Both pharmacological and non-pharmacological interventions were associated with reduced pain during AV fistula insertion. Among the reviewed interventions, 2% lidocaine gel and cryotherapy at the Hegu point were the interventions most consistently associated with pain reduction. Conclusion: Both pharmacological and non-pharmacological interventions were associated with reduced pain during AV fistula insertion. Among the reviewed interventions, 2% lidocaine gel and cryotherapy at the Hegu point showed the most consistent associations with pain reduction. These findings may inform pain management practices in hemodialysis settings.]]>
